Kornimate/medical-research-clean huggingface dataset:
a cluster randomized controlled trial to compare the rate of antibiotic infusion

Conditions: Acute Upper Respiratory Tract Infection; Bacterial Infections

Summary: acute upper respiratory tract infection, commonly known as upper respiratory infection, is an acute inflammation primarily affecting the nose, pharynx, or larynx caused by various viruses and/or bacteria. viruses are more common, accounting for 70% to 80% of cases, while bacterial infections account for 20% to 30%. for a long time, the high rate of intravenous infusion use has been a prominent issue in clinical diagnosis and treatment in china. the irrational and excessive use of antimicrobials in emergency patients with upper respiratory tract bacterial infections has also become increasingly apparent, imposing unnecessary financial burdens and risks of drug side effects on patients. therefore, reducing the rate of intravenous antimicrobial administration in emergency patients with upper respiratory tract bacterial infections has become an urgent problem to be solved. by implementing measures such as health education by clinical pharmacists and enhancing the awareness of rational antimicrobial use in doctors, it is expected to lower the rate of intravenous antimicrobial administration, reduce the occurrence of drug resistance, improve treatment convenience for patients, and lower treatment costs while ensuring therapeutic efficacy. the purpose of this study was to investigate whether clinical pharmacists can reduce the intravenous infusion rate of antimicrobials in emergency patients with upper respiratory tract bacterial infections through medication education for emergency medical staff and to observe whether this intervention will affect the prognosis and medication safety of these patients.


Eligibility criteria:
inclusion criteria: * patients with upper respiratory tract infections seeking emergency medical attention; * patients with laboratory tests indicating white blood cell (wbc) \>10×10\^9/l or white blood cell (crp) ≥ 10.0mg/l, requiring the use of antimicrobial agents; * patients aged ≥ 18 years; ④ patients with at least one of the following local signs and symptoms: (1) fever, (2) cough, (3) rhinitis (sneezing, nasal congestion, or rhinorrhea), (4) pharyngitis (sore throat), (5) shortness of breath, (6) wheezing, (7) chest pain, (8) abnormal auscultation findings. exclusion criteria: * patients with other infections in addition to upper respiratory tract infections; ② patients who require hospitalization or treatment in a higher-level medical institution as assessed by medical professionals; * patients who cannot take oral medications or have severe gastrointestinal dysfunction; ④ special patients, including those with neutropenia, bone marrow suppression, during radiochemotherapy, undergoing immunosuppressive therapy, human immunodeficiency virus (hiv)-positive patients, patients with congenital immune deficiency, pregnant patients, and patients with mental illnesses.

Keywords: bacterial infection of upper respiratory tract infusion rate pharmacist
prospective post-market data collection for ion endoluminal system to understand ct to body divergence

Conditions: Lung Cancer; Pulmonary Nodule, Solitary

Summary: the goal of this study is to collect post-market data for the ion endoluminal system to understand ct to body divergence.


Eligibility criteria:
inclusion criteria: * age of 18 years or older * undergoing a lung biopsy procedure with ion system * have peripheral pulmonary lesion (5th bronchial generation or higher) * willingness to participate as demonstrated by signing the informed consent exclusion criteria: * unable to provide informed consent * presence of bilateral nodules intended to be biopsied during procedure * the presence of medical conditions contraindicating general anesthesia or bronchoscopic biopsy * vulnerable population (e.g., prisoners, mentally disabled)
prevalence of dissociative disorders in children

Conditions: Dissociative Disorders; Schizophrenia

Summary: schizophrenia beginning before 18 years is a clinical entity not well known because of its low incidence and difficulties in the clinical diagnosis. however, in the investigators clinical practice, due to the specialization of the investigators service, the investigators are led to hospital to receive important feel active of patients meeting the diagnostic and statistical manual of mental disorders iv text revision (dsm iv-tr) precose schizophrenia. the work of us team on the theme of the relationship between pervasive developmental disorders and precose schizophrenia led us to hypothesize that a number of children in care in the medical and educational institutes, hospitals and day shelters therapeutic part-time symptoms of schizophrenia or a line real early diagnosis of schizophrenia undervalued or not diagnosed. the main goal is to estimate the prevalence of dissociative disorders in a population of children in care institutions and medical education in child psychiatry in hospitals and others structures.


Eligibility criteria:
inclusion criteria: * 7 to 18 years * supported in the partner institutions of the study * iq\>35 on the certificate of orientation of the maison départementale des personnes handicapées (mdph) * obtaining the agreement of parents and children exclusion criteria: * qi\<35 on the certificate file guidance mdph * children not speaking french

Keywords: children dissociative disorders schizophrenia
head cooling in ischemic stroke patients undergoing endovascular thrombectomy: a feasibility and safety study

Conditions: Stroke, Acute

Summary: this is an investigator-initiated, prospective, open-label, single-arm, non-randomized study to assess the safety and feasibility of external active conductive head cooling during endovascular thrombectomy procedures.


Eligibility criteria:
inclusion criteria: - all patients with anterior circulation acute ischemic stroke planned to undergo endovascular thrombectomy will be screened for recruitment. exclusion criteria: * admission core body temperature \<35°c. * known contraindications to hypothermia, including hemodynamically unstable patients, new/symptomatic arrhythmia, hematological dyscrasias that affect thrombosis (cryoglobulinemia, sickle cell disease, serum cold agglutinins), or vasospastic disorders such as raynaud's or thrombo-angiitis obliterans. * skin lesions not allowing secure application of the cooling cap. * unable to participate in follow-up at 3 months (e.g., resides outside of alberta).

Keywords: hypothermia large vessel occlusion neuroprotection
risk evaluation and stratification of low risk for cardiovascular disease in women

Conditions: Chest Pain

Summary: this study will evaluate the ability of coronary computed tomography angiography (ccta), used as a first-line diagnostic tool in women with stable chest pain and low risk for coronary artery disease (cad), to reduce the number of women requiring more than one diagnostic test to rule in or rule out cad. half of the participants will undergo ccta as the first test to investigate stable chest pain, while the other half will undergo any test ordered by their family physician.

coronary artery disease (cad) is the leading cause of death in women globally. women are more likely to present with atypical chest pain that may be difficult to diagnose using traditional testing methods, resulting in over-investigation. coronary computed tomography angiography (ccta) has high negative predictive value for exclusion of cad in low to intermediate risk populations. we plan to investigate ccta as a first line test to exclude coronary artery disease as a cause of stable chest pain and whether it is a cost effective strategy that reduces time to diagnosis, wait times to see cardiologists, emergency department visits, downstream and repeat testing and radiation exposure as compared to usual care with comparable patient safety and satisfaction level. another intervention being tested in this trial is the cardiac link pathway. this is a new clinical program at women's college hospital that aims to expedite cardiology referral for patients exhibiting clinically significant findings while undergoing cctas. we hope that with use of ccta as the first test, the number of women who require only one test (i.e. ccta) to sort out whether or not cad is responsible for their chest pain will increase, thereby decreasing over-investigation of low risk women.

Eligibility criteria:
inclusion criteria: * men and women age ≥ 40 years of age * stable chest pain or equivalent symptoms * planned non-urgent, non-invasive testing for diagnosis of chest pain or equivalent symptoms exclusion criteria: * acute coronary syndrome, including acute myocardial infarction or unstable angina, known non-ischemic cardiomyopathy or other cardiac disease (e.g. mitral valve prolapse, etc.) which would require urgent cardiac evaluation * known cad * prior cardiac evaluation for current episode of symptoms * previously investigated for cad in the last 12 months * severe allergic reaction to iodinated contrast (mild reactions such as urticaria that can be controlled by premedication with benadryl \& prednisone may be included in the study) * renal failure or dysfunction (estimated glomerular filtration rate\<30ml/min/m2 within the past 3 months) * pregnancy (status will be confirmed verbally. for premenopausal patients who are unsure, status will be confirmed by completing a pregnancy strip test).

Keywords: angina
automatic differentiation of innocent and pathologic murmurs in pediatrics

Conditions: Heart Murmurs; Mitral Valve Prolapse; Systolic Murmurs

Summary: the purpose of this preliminary clinical study is to assess the quality of a computational algorithm that automatically classifies murmurs of phonocardiograms (pcgs) as either pathologic (aha class i) or as no- or innocent (aha class iii) in the pediatric population. each patient is auscultated and diagnosed independently by a medical specialist by means of a standard mechanical stethoscope. additionally, for each patient, a pcg is recorded using a littmann 3200 electronic stethoscope and later analyzed using the computational algorithm. an echocardiogram is performed as the gold-standard for determining heart pathologies. the results of the computer aided auscultation (caa) are compared to the findings of the medical professionals as well as to the echocardiogram findings. hypothesis: the specific caa algorithms used in this study are able to differentiate pathologic (aha class i) from no- or innocent murmurs (aha class iii) in a pediatric population.

background: computer aided auscultation in the differentiation of pathologic (aha class i) from no- or innocent murmurs (aha class iii) would be of great value to the general practitioner and potentially also to the specialist. this would allow objective screening for structural heart disease, standardized documentation of auscultation findings, and may avoid unnecessary referrals to pediatric cardiologists. our goal was to further develop and assess the quality of a novel computational algorithm that automatically classifies murmurs of phonocardiograms (pcgs) acquired in a pediatric population. methods: patients with no-, innocent-, and pathologic murmurs were recruited from the general pediatric cardiology clinic. using an electronic stethoscope, pcgs were acquired by the pediatric cardiologist from each patient. the pcgs were analyzed by the algorithm and diagnoses were compared to findings by the pediatric specialist and echocardiography as the gold standard. the following registry procedures and quality factors have been implemented in this preliminary clinical study: * quality assurance plan, including * data validation * proper registration procedures * source data verification to assess the accuracy, completeness, or representativeness of registry data by comparing the data to external data sources (medical records and paper case report forms). * standard operating procedures to address registry operations and analysis activities, including patient recruitment, data collection, data management, data analysis.

Eligibility criteria:
inclusion criteria: * outpatient * parental approval for study participation exclusion criteria: * none

Keywords: computer aided auscultation (caa) electronic stethoscope phonocardiography heart auscultation
a comparative study on the efficacy of different stepping-down therapy for childhood asthma

Conditions: Asthma in Children

Summary: this study is a 24-week, randomized, parallel group comparative effectiveness study to evaluate the risk of stepping down therapy for patients with well-controlled asthma treated with combination inhaled corticosteroids (ics) and leukotriene receptor antagonist（ltra).

asthma guidelines recommend stepping down therapy once asthma is controlled for at least 3 months. leukotriene receptor antagonist（ltra). for children with mild persistent asthma, ics twice a day combined with ltra can be used for treatment, but there is no consensus on how to reduce drugs in patients with asthma that is well controlled (reducing the dose of ics or stopping montelukast). we propose a 24-week, randomized, parallel group comparative effectiveness study comparing three approaches in patients with asthma well-controlled for at least three months on combination ics and ltra: halve the dose of ics firstly and then stop ics with montelukast only, stop montelukast firstly and then halve the dose of ics, and halve the dose of ics firstly and then stop montelukast. our goal is to compare the rate of treatment failure and determine the optimal treatment strategy. additional goals include assessing risk factors for step-down failure.

Eligibility criteria:
inclusion criteria: * age 4-14 years * patients had mild to moderate persistent asthma. patients have treated with low-dose inhaled corticosteroids (equivalent to fluticasone propionate inhaled aerosol 250 ug/ day) combined with leukotriene receptor antagonist (montelulast) at least 6 months of and had no symptoms of asthma for nearly 3 months under well asthma control(asthma control test (act) score more than or equal to 20). * patients did not suffer from other acute or chronic diseases that may affect their growth and development exclusion criteria: * patients with severe persistent asthma or mild persistent asthma failed to be well controlled by low-dose ics after starting treatment * suffer from other diseases: congenital heart disease, chronic infectious disease, protracted diarrhea, congenital airway disease, congenital vascular ring malformation, congenital immune deficiency, tracheal foreign body, bronchial lymph node tuberculosis and gastroesophageal reflux etc. * patients with poor compliance stop medication or fail to take medication on time.
predictive nature of total cholesterol threshold: possible link to suicidal behavior

Conditions: Current Major Depressive Disorder

Summary: suicidal behavior (sb) is a public health problem. the clinical model currently admitted to the understanding of sb is a stress vulnerability model, but so far, all scientific works has no clinical application. the management of psychiatric patients, including depressed subjects, faces the inability to detect those with a high risk of sb. many studies have shown a link between low cholesterol and sb. a study has recently proposed a total cholesterol threshold below which the risk of suicide could be increased. however, a prospective study is needed to assess the predictive nature of such an indicator.

investigators propose to assess, within a cohort of patients, the predictive value of a total cholesterol threshold in the occurrence of sb. 555 inpatients suffering from a current major depressive disorder (mdd), hospitalized in the department of emergency psychiatry and post acute care will be recruited. each patient will attend a total of 5 visits during a follow-up period of 18 months (visits at 1, 3, 6, 12, and 18 months)

Eligibility criteria:
inclusion criteria: * major * meet the diagnostic and statistical manual of mental disorders-iv (dsm) criteria for a major depressive episode * subject who signed the non-opposition form * able to understand the nature, purpose and methodology of the study * able to understand and perform the clinical and neuropsychological evaluations. exclusion criteria: * subject whose primary psychiatric diagnosis is not a major depressive episode according to dsm-iv criteria (the existence of psychiatric comorbidity is not a criterion for non-inclusion) * refusal of participation * subject deprived of liberty (by judicial or administrative decision) * subject protected by law (guardianship) * subject exclusion period in relation to another protocol * subject for which the maximum annual amount of allowances of € 4,500 has been reached * subject not affiliated to a social security scheme or not being the beneficiary of such a scheme.

Keywords: depression cholesterol suicidal behavior predictive factor
the effect of local anesthesia and simple maneuver on shoulder pain after gynecologic laparoscopy

Conditions: Gynecologic Laparoscopic Surgery for Benign Adnexa Disease

Summary: this prospective, randomized controlled trial was designed to compare the efficacy of a simple maneuver using lower airway pressure (30 cm h2o) and intraperitoneal instillation of bupivacaine, alone or in combination, to reduce shoulder pain after gynecologic laparoscopy. patient aged 15-65 years, scheduled for laparoscopic surgery for benign adnexa disease will be eligible for the study. patients will be excluded from analysis if the procedure requires conversion to a laparotomy, an operative time \> 3 hours, or interpretation of pain is impossible due to serious adverse effects 240 patients will be randomly assigned to one of four groups upon completion of surgery, the patient is placed in the trendelenburg position (30 degrees), and one of four procedures is followed. for group a (control), 50 ml of normal saline is instilled under the diaphragm and co2 is removed by manual deflation of the abdominal cavity through the cannula; for group b, a mixture of 50ml solution (20ml of 0.5% bupivacaine + 30ml normal saline) is instilled under the diaphragm and co2 is removed by manual deflation of the abdominal cavity through the cannula; for group c, 50 ml of normal saline is instilled under diaphragm and co2 was removed by means of a pulmonary recruitment maneuver consisting of five manual inflations of the lung with a maximum pressure of 30 cm h2o. the anesthesiologist holds the fifth positive pressure inflation for approximately 5 seconds. during these maneuvers, the surgeon will be instructed to ensure that the trocar sleeve valve is fully open to allow the co2 gas to escape. for group d, patients receive an instillation of a mixture of 50ml solution in combination with the clinical maneuver. patients will be given a questionnaire with the pain question represented as a visual analog scale (vas) preoperatively. patients will be asked to fill out the questionnaires during the first 24 hours after surgery to determine the frequency and severity of their shoulder pain. all patients are instructed to record the pain scores regarding their shoulder pain only. the degree of postoperative shoulder pain will be assessed using vas at 1, 6, 12, and 24 hours postoperatively. the vas, with scores ranging from 0 (no pain) to 10 (excruciating pain), is constructed without numeration, thus allowing patients to mark a point along the scale that best represented their pain at that time. in addition, the following parameters are recorded on the case report form by the investigators: operative time, blood loss, the length of hospital stay, analgesic use, and incidence of postoperative events.


Eligibility criteria:
inclusion criteria: * benign adnexa diseases which are scheduled for laparoscopic surgery exclusion criteria: * the procedure required conversion to a laparotomy, an operative time \> 3 hours, interpretation of pain was impossible due to serious adverse effects.
octaplas pediatric plasma replacement trial

Conditions: Liver Surgery; Liver Dysfunction; Coagulopathy; Cardiac Surgery

Summary: the purpose of this study is to investigate the safety, tolerability and efficacy of octaplas in pediatric patients who require replacement of multiple coagulation factors. replacement of multiple coagulation factors in pediatric patients with acquired deficiencies due to liver disease and/or in pediatric patients requiring cardiac surgery or liver surgery.


Eligibility criteria:
inclusion criteria: 1. patient requiring liver or cardiac surgery and/or patient with liver dysfunction associated with coagulopathy in whom replacement of multiple coagulation factors is required. 2. voluntarily given, written and signed informed consent by the patient's legal representative(s) or guardian(s). children deemed old enough by the investigator/institution to understand the risks and benefits of the study should also be made aware of the risks/benefits of the study and provide written assent. 3. male or female patient ≤ 16 years of age. exclusion criteria: 1. patient with known homozygous congenital deficiency of protein s. 2. patient has a history of hypersensitivity reaction to blood or plasma-derived products or to any excipient of the investigational product. 3. patient has an already known iga (immunoglobulin a) deficiency with documented antibodies against iga. 4. patient has a congenital factor deficiency or platelet disorder requiring plasma treatment. 5. patient is currently participating in another study investigating a new drug product or another interventional clinical study that may impact coagulation factors or has participated during the last three (3) months. 6. patient received ffp (fresh frozen plasma), fp24 (plasma frozen within 24 hours of collection) or any other plasma product other than octaplas within the last 72 hours (cryoprecipitate and albumin are not exclusionary) prior to first octaplas infusion. 7. patient is on ecmo (extracorporeal membrane oxygenation) when plasma is ordered by the treating physician for the first infusion episode. 8. patient is pregnant. 9. patient is predicted to require massive blood transfusion defined as more than 40 ml per kilogram of all blood products in a 24-hour period 10. patient is receiving plasma exchange, therapeutic plasma exchange (tpe) or plasmapheresis. 11. patient is a premature neonate defined as less than 37 weeks gestation. 12. cardiac surgery patients who develop the need for plasma replacement greater than 72 hours after the end of the associated cardiac surgery and do not have coagulopathy due to hepatic dysfunction.

Keywords: pediatric patients replacement coagulation factors plasma s/d plasma octaplas plasma replacement